Cost Cutting/Budgeting --- the patients suffer the most

  1. 6 So, In an effort to "control costs" the hospital has taken DRASTIC and UNSAFE steps to save money. Honest to God ( NO JOKE) a partial list of the new policies are listed below. There are three 20-bed units on my floor (all general Med/Surg) keep that in mind.

    - No more morning and evening shift unit secretary. Now secretary will be 12-hour shift from 9am-9pm. No more secretary on each unit. Now the secretary will spend 1 hour on each unit on the floor ("Rotating").

    - No more CNA for each unit. Now CNA will rotate between all three units 1 hour on each unit.

    - If a patient need to be a sitter, No more floating extra CNAs or calling in Registry CNAs. Now the CNA will be the sitter. If more than 1 patient is needed to be sitter, the sitter patients will be moved together. If patients needing sitter are ISOLATION and other are NON-ISOLATION, the new protocol is to co-hort the non-isolation "healthy" person with the isolation patient and make sure handwashing and infection control measures are followed. If 3 or more patients need to be sitters, the family conference room will be converted as a multi-bed ward for this purpose.

    - No more housekeeping on the units. CNA and RN staff will be preforming housekeeping duties in addition to patient care.

    - No more individual case managers per unit --- Now 1 case manager per entire floor.

    - 1 Team Leader per floor --- no more individual unit team leader per shift.

    Welcome to the new world order - Healthcare Nazi-ism! Enslaved and over worked staff ensure that higer ups can recieve their $5,000 bonus this year.
    Last edit by Joe V on Nov 28, '12 : Reason: spacing
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  3. Visit  abbaking profile page

    About abbaking

    From 'Phoenix'; Joined Dec '06; Posts: 456; Likes: 1,557.

    34 Comments so far...

  4. Visit  Testa Rosa, RN profile page
    7
    Sounds like you work for the highly profitable "not for profit" Sutter System to me--or a Hospital trying to copy it's model. I am not against Hospital Groups being profitable--in fact I endorse it as it is what allows California Hospitals to replace aging and earthquake unsafe buildings and to introduce innovations like computerized charting and new surgical instruments. Yet when that profit goes to feed upper management in such grossly disproportionate ways, I draw the line.

    I often care for a full load of total care patients with not one CNA. Everyone is so pushed to the max I feel unsupported. No lift teams or even time available to use the poorly supplied mechanical lifts they provide because I am constantly dealing with short staffed pharmacy in a mad scramble to get my patients their meds on time.

    And now they want to gouge the RN's by trying to take our salaries and benefits to the 70's. We have been fighting back with strikes just to keep what we have fought so hard to earn. As a trusted care provider I am held to the highest ethical standards yet my upper management has behaved badly, telling boldfaced lies to the media and to their staff. I have never seen nurses so disrespected as they are at my facility. I will have no sick leave when I throw my back out. The upper management has hired bullies and lateral violence has come back with a vengeance in this facility--high quality nurses who have worked there for years and have trained me are being forced out and replaced with travelers from other states. They are enjoying the healthiest profit margins in years, yet cite "poor economy" as they have cut major services left and right.

    I rarely get a pee break and chart thru lunch because the staff is so pushed to the max there is little support. This is not safe working conditions--yet Sutter is one of the most profitable "non profits" enjoying a healthy bottom line and huge upper management salaries and perks to prove it. We need to let the public know what is going on at bedside. Resources that should be at bedside are going to the boardroom. Sutter is using gouging staff and draining services in order to use my facility as a cash cow to feel it's upper levels. I am so angry at the unsafe, hostile conditions and lies--the "Nazi" approach you so perfectly voiced--that I feel compelled to take action. I haven't figured out what I'm going to do yet, but we nurses need to go to the media with our concerns.
    Cranberrygirl, somenurse, 1PACURN, and 4 others like this.
  5. Visit  Forever Sunshine profile page
    9
    The housekeeping duties that have to be done by the nurses just baffles me.. "aint nobody got time for that."

    Sweet Brown - Ain't Nobody Got Time for That (Autotune Remix) - YouTube .. sadly but this is the theme song for nurses these days.
    Hygiene Queen, somenurse, canchaser, and 6 others like this.
  6. Visit  Silverlight2010 profile page
    7
    Isolation and non-isolation patients rooming together to save on sitter costs? Wonder how long that will last after the first lawsuit by an outraged family/ SDM if the non-isolation patient becomes infected. Housekeeping duties? When do they think the nurses will have time for that with all the other cuts? Sheesh.
  7. Visit  wooh profile page
    5
    Quote from Testa Rosa, RN
    Sounds like you work for the highly profitable "not for profit" Sutter System to me--...
    Or HCA...
    gypsyd8, Sun0408, somenurse, and 2 others like this.
  8. Visit  JZ_RN profile page
    1
    I am a nurse, not a housekeeper. I would flat our REFUSE to do any housekeeping. Everything else is asinine too but that is just degrading.
    somenurse likes this.
  9. Visit  SHGR profile page
    3
    How silly. Case managers save money, no? And housekeeping makes less money per hour than nursing staff, no? Awesome how the place will shoot itself in the foot trying to save money...while harm patients,and alienating nurses and the community in the process.
    somenurse, xoemmylouox, and KelRN215 like this.
  10. Visit  That Guy profile page
    23
    Hmmm, this might be useful to you

    Writing a Resignation Letter
    calivianya, gypsyd8, Not_A_Hat_Person, and 20 others like this.
  11. Visit  Ntheboat2 profile page
    1
    It says no more housekeeping on units...

    That doesn't necessarily mean that they expect nursing staff to do the housekeeping. Where I used to work and where I'm about to start working there isn't housekeeping on the units...

    But you page them if they're needed and they come. In the meantime, they are doing rounds where they're gathering the trash, mopping, etc.

    You can't be saying that they expect nurses to fill up mop buckets and clean the floors, scrub the toilets, etc. Nobody likes change, but surely it's not THAT drastic?
    rn865 likes this.
  12. Visit  kcmylorn profile page
    13
    If you guys live in California- write all this down, with name date and time and send your letters of complaints to the CNA/NNU AND your Department of Health, your congress people, your senators and the media. The manamgnet gets away with this becasue no one comlains or exposes them.
    gypsyd8, somenurse, Testa Rosa, RN, and 10 others like this.
  13. Visit  Anna Flaxis profile page
    14
    Quote from Testa Rosa, RN
    I rarely get a pee break and chart thru lunch because the staff is so pushed to the max there is little support.
    This is part of the problem. When nurses work off the clock like this, it looks on paper like you are capable of handling the workload that is being asked of you.

    If just one or a few nurses refuse to do this, then it is easy for them to be singled out as poor time managers.

    However, if you create a culture on your unit where your federally mandated rest and meal breaks are taken and nobody stays late to finish charting (or overtime is requested either due to missing breaks or having to stay late to chart), then it will be apparent that it's not just a few "troublemakers" and that the nurses are overworked, and the idea that the nurses can handle an unrealistic workload becomes indefensible.
    tewdles, catlvr, lindarn, and 11 others like this.
  14. Visit  DSkelton711 profile page
    5
    I have been a nurse for 26 years. No way would I think of becoming one these days. Bless all you newbies out there.
    tewdles, lindarn, Testa Rosa, RN, and 2 others like this.
  15. Visit  kcmylorn profile page
    11
    Quote from ~*Stargazer*~
    This is part of the problem. When nurses work off the clock like this, it looks on paper like you are capable of handling the workload that is being asked of you.

    If just one or a few nurses refuse to do this, then it is easy for them to be singled out as poor time managers.

    However, if you create a culture on your unit where your federally mandated rest and meal breaks are taken and nobody stays late to finish charting (or overtime is requested either due to missing breaks or having to stay late to chart), then it will be apparent that it's not just a few "troublemakers" and that the nurses are overworked, and the idea that the nurses can handle an unrealistic workload becomes indefensible.

    Agreed- this has to be done across the board, and not just in one facility but all facilites nurses work in. It's not just happening in one facility, on one unit, to one or a few nurses. This is a universal problem. It's not just a clinical nursing problem, the original poster mentioned"case managment" involved also.
    This is common knowledge for all of us, nurses. it's happening in hospitals, home health and LTC. In every one of these venues the end user is the patient.

    I am waiting for the 1 darn good explaination of why health has to pay a multimillion dollar( a
    Sultan's" salary)to 1 individual- the CEO at the expense of the patient in these beds, homes, or where ever the patient is; just because, their marketing ability, their(tongue in cheek) "business saavy will not cut it. We are seeing progressively more and more of their dangerous, reckless, unaccoutable, continued cost cutting acts. It's getting worse and worse, it like "how low can you go under the limbo stick before the stick or the system falls down.
    It's time nursing grew a pair and stood up as a large group to these CEO's. It's out profession not theirs.

    If what the CMS and Joint commission lay down as regulations bother us nurses, it shouldn't. These are regulation agencies- that's their job. Why should CMS pay for hospital aquired infections because the nurse is to spread thin to closely monitor 7,8,10 acutely(2012 acutely ill patients)ill patients. It's not the CMS' job to keep feeding the fiscal mis manamgent of our greedy healthcare CZARS. It's not a reflection on the nurse at the point of care, this is a reflection on the fiscial managment of the institution they work for. The beside nurse is just the easiest one to get rid of. They can process variance/risk manage/ insident report all they want- they are still not solving the problem. There will still be another nurse who comes along and does the same thing or a variation of the same thing. Why? Try too much work for 1 person. There is something wrong with the thought process at the top, not at the point of care.- It's called "Greed based care" not "Evidenced based practice"
    Last edit by kcmylorn on Nov 25, '12
    tewdles, Cranberrygirl, lindarn, and 8 others like this.


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